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DyskinesiasNCT05044572

Comparison of Open Chain Kinetic Exercises and Forward Head Posture Correction in Type II Scapular Dyskinesia

A study testing Open chain kinetic exercises and Forward head posture correction exercises in people with Dyskinesias, run by Riphah International University at 1 site in Pakistan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The objective of this study is to compare the effect of open chain kinetic exercises and forward head posture correction on scapular symmetry and glenohumeral disability in office workers with type II scapular dyskinesis. Read more about this study

Who is it for?
Ages 20 to 40 years
Conditions the study is for
Dyskinesias
What is being tested?
Open chain kinetic exercises and Forward head posture correction exercises
Could I receive a placebo?
No, everyone receives an active treatment
How many people
42 participants
Where
1 sitePakistan
Study dates
15 Sep 2021to 25 Feb 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 to 40 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Both male and female office workers
  • In the age group of 20 to 40 years
  • With at least one year work experience
  • Individuals with Type II scapular dyskinesia (1-1.5 cm dif¬ference)
  • Individuals with forward head posture

Who cannot join

  • Any Congenital abnormality
  • Neurological deficit
  • Received physiotherapy treatment in past three months

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • Sarwat Anwar Medical Complex Hospital

    Lahore, Punjab Province, 54000

Other trials in Pakistan

About this study

Official title: Comparison of Open Chain Kinetic Exercises and Forward Head Posture Correction on Scapular Symmetry and Glenohumeral Disability in Office Workers With Type II Scapular Dyskinesia

The objective of this study is to compare the effect of open chain kinetic exercises and forward head posture correction on scapular symmetry and glenohumeral disability in office workers with type II scapular dyskinesis.

Read the detailed description

The scapula plays a crucial role in coordinating and maintaining complex shoulder kinematics. The rotator cuff (RC) and the scapula control energy and force transfer for glenohumeral (GH) and scapulothoracic (ST) movements. From a biomechanical perspective, the shoulder range of motion (ROM) covers almost 65% of a spherical joint whose stability is ensured by several factors such as bone integrity, muscle activity, and ligaments.The RC and scapula allow for three-dimensional movements of the shoulder by limiting excessive translations that may compromise the joint integrity.The overall prevalence of scapular dyskinesis was 90.08%, and the highest frequency was found at the resting position.

Association between ergonomic risk level and scapular dyskinesis in office workers in 2020. It was a cross sectional study A lateral scapular slide test (LSST) was used to evaluate scapular dyskinesis, and the quick exposure check (QEC) method was used to analyze the ergonomic risk level. results indicate that patients with scapular dyskinesis have a high ergonomic risk level.

A defective scapular posture, caused by muscular imbalances, also generates imbalances of length and muscular strength in the muscles, altering the mechanics of the glenohumeral joint. A forward bending of the scapula is associated with a retracted minor pectoral muscle and possibly anterior serratus weakness or trapezius. This scapular posture alters the humeral posture on the glenoid, assuming a relatively abducted and internally rotated position, resulting in retracted glenohumeral internal rotators and elongated or weak lateral rotators.

SW Christensen et al has stated in an article that the key group that might be related with scapular dyskinesis and work-related pain in office workers is the axioscapular muscles. These muscles attach between the scapula to the axis of the body consisted of serratus anterior, Pectoralis minor, rhomboids, levator scapulae and three parts of trapezius.

Study in 2016 in which the deeper lying (Levator Scapulae, Pectoralis Minor (Pm) and Rhomboid major) and superficial lying (Trapezius and Serratus Anterior) scapulothoracic muscles' activity was investigated with fine-wire and surface EMG, concluded that In the presence of idiopathic neck pain, higher Pectoralis minor activity during the towel wall slide was found. Patients with neck pain and scapular dyskinesis showed lower MT(middle trapezius) activity in comparison with healthy controls with scapular dyskinesis during scaption.

In 2018 The results showed high incidence of axioscapular muscle adaptations including of decreased flexibility of pectoralis minor, upper trapezius and levator scapulae in all subtypes as well as decreased performance of serratus anterior, middle trapezius, lower trapezius and rhomboids. The high incidence of postural deviations including forward head, rounded shoulder and thoracic hyper-kyphosis were also found in all subtypes of scapular dyskinesis. The participants were symptomatic office workers with different subtypes of scapular dyskinesis. They were evaluated the subtypes of scapular dyskinesis corresponded with flexibility of pectoralis minor, upper trapezius and levator scapulae using muscle length tests. The performances of serratus anterior, upper trapezius, middle trapezius, lower trapezius and rhomboids were also examined using manual muscle test. The postural deviations of cervical, shoulder and thoracic were also investigated using postural analysis methods.

Conventional therapeutic exercise programs are commonly used to treat patients with scapular dyskinesis. It is common for physical therapists to treat patients with shoulder pain and scapular dyskinesis. Treatment techniques to address dyskinesis include manual neuromuscular facilitation, tactile cueing, visual feedback, electrical stimulation, supervised exercise, mobilization, strengthening, electromyography, and other interventions.

An RCT in which eleven asymptomatic university students representing 15 scapulae with a positive Scapular Dyskinesis Test were recruited as subjects. Participants were randomized into exercise and electrical stimulation (ESTherex) or exercise and sham electrical stimulation (ShamTherex) and stated that Electrical stimulation with exercises for scapular dyskinesis showed improvements in spine to scapula distance at 120 degrees of shoulder abduction.

The literature has proved that shoulder stabilization training strengthens the scapular muscles, closed chain and open chain kinetic exercises are also beneficial thereby resolving the SD. But as FHP can lead to SD, among the correction of FHP or open chain kinetic exercises which one is more effective to treat SD type II it has not been compared before. There is also paucity of literature available on open chain kinetic exercises and forward head posture correction exercises on scapular symmetry and glenohumeral disability in office workers with type II scapular dyskinesis. Hence this study aims to compare the effect of open chain kinetic exercises and forward head posture correction on scapular symmetry and glenohumeral disability in office workers with type II Scapular dyskinesis.

Conditions
Dyskinesias
Being tested
Open chain kinetic exercises, Forward head posture correction exercises
Keywords
Scapula
Medical subject headings
Dyskinesias

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Open chain kinetic exercisesOther

    Group A will perform open chain kinetic exercises Before the intervention all the participants will perform 20 minutes of warm up and 10 minutes of cool down. The Open kinematic chain exercises(Three sets of each exercise while one set of each exercise will be performed at the setup and remaining two sets will be guided to the patient as a home plan)-:Blackburn exercises ( 20 repetitions ) , Dynamic hug( 10 repetitions), W exercise(10 repetitions), lunges with dumbbells-forward(10 repetitions with half kg dumbbell), upward and diagonal, and Pectoralis minor stretching(3 to 5 stretches)will be performed

  • Forward head posture correction exercisesOther

    PatienGroup B participants will perform forward head correction exercise(22) Chin tuck Patient will Stand with upper back against a wall, feet shoulder-width apart. • Face forward, tuck your chin down, and pull head back until it meets the wall. • t

Study groups in NCT05044572
Study groupRoleWhat they receive
Open chain kinetic exercisesExperimentalNot described
Receives: Other: Open chain kinetic exercises
Forward head posture correction exercisesExperimentalNot described
Receives: Other: Forward head posture correction exercises

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. SPADI questionnaire

    The Shoulder Pain and Disability Index (SPADI) was developed to measure current shoulder pain and disability in an outpatient setting. The SPADI contains 13 items that assess two domains; a 5-item subscale that measures pain and an 8-item subscale that measures disability.

    Measured: 4 week

  2. Lateral Scapular Slide Test (LSST)

    Lateral Scapular Slide Test (LSST) will be used to evaluate the scapular dyskinesis. LSST asses scapular asymmetry under varying load positions. Measurements of scapular position are taken while scapular position with the arm abducted 0, 45, and 90 degrees in the coronal plane. Distance from the inferior angle of the scapula to the spinous process of the thoracic vertebra in the same horizontal plane was measured in all 3 position .If the distance is greater than 1.5 cm, it means LSST is positive

    Measured: 4 weeks

  3. Forward head posture measurement using Image J software

    Forward head posture measurement will be assessed using a digitized , lateral view photograph(Sony 16.1 M pixels camera ) of the subject in his or her usual standing posture. The tragus of the subject's ear will be marked and a reflexive marker will be attached to the skin overlying C7 vertebrae. Once the photograph obtained we will use ImageJ software (20)to measure FHP quantified by the craniovertebral angle (The angle between the horizontal line passing through the C7 and a line extending from tragus of ear to C7). An angle less than 50-53 degrees may indicate FHP . Thereby, the smaller the CV angle, the greater the disability.

    Measured: 4 weeks

  4. Universal Goniometer

    In Type 2 Scapula Dyskinesia, weakness of the serratus anterior results in reduction in both glenohumeral flexion and abduction .So these ranges will be measured before and after intervention in both groups with the help of goniometer.

    Measured: 4 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Sep 2021
  2. Study start15 Sep 2021
  3. Primary completion15 Feb 2022
  4. Study completion25 Feb 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
42 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05044572
Sponsor's protocol ID
REC/0122 Sidra Ali
Status last verified
Mar 2022
First submitted
13 Sep 2021
Last updated
10 Mar 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Lefevre-Colau MM, Nguyen C, Palazzo C, Srour F, Paris G, Vuillemin V, Poiraudeau S, Roby-Brami A, Roren A. Recent advances in kinematics of the shoulder complex in healthy people. Ann Phys Rehabil Med. 2018 Jan;61(1):56-59. doi: 10.1016/j.rehab.2017.09.001. Epub 2017 Sep 28. No abstract available.

    PubMed 28964876
  • Lefevre-Colau MM, Nguyen C, Palazzo C, Srour F, Paris G, Vuillemin V, Poiraudeau S, Roby-Brami A, Roren A. Kinematic patterns in normal and degenerative shoulders. Part II: Review of 3-D scapular kinematic patterns in patients with shoulder pain, and clinical implications. Ann Phys Rehabil Med. 2018 Jan;61(1):46-53. doi: 10.1016/j.rehab.2017.09.002. Epub 2017 Oct 5.

    PubMed 28987866
  • Kibler WB, Sciascia A. The role of the scapula in preventing and treating shoulder instability. Knee Surg Sports Traumatol Arthrosc. 2016 Feb;24(2):390-7. doi: 10.1007/s00167-015-3736-z. Epub 2015 Aug 1.

    PubMed 26231154
  • Deng S, Chen K, Ma Y, Chen J, Huang M. The Influence of Test Positions on Clinical Assessment for Scapular Dyskinesis. PM R. 2017 Aug;9(8):761-766. doi: 10.1016/j.pmrj.2016.11.011. Epub 2016 Dec 1.

    PubMed 27916706
  • Panagiotopoulos AC, Crowther IM. Scapular Dyskinesia, the forgotten culprit of shoulder pain and how to rehabilitate. SICOT J. 2019;5:29. doi: 10.1051/sicotj/2019029. Epub 2019 Aug 20.

    PubMed 31430250
  • Longo UG, Risi Ambrogioni L, Berton A, Candela V, Massaroni C, Carnevale A, Stelitano G, Schena E, Nazarian A, DeAngelis J, Denaro V. Erratum: Longo, U.G., et al. Scapular Dyskinesis: From Basic Science to Ultimate Treatment. International Journal of Environmental Research and Public Health 2020, 17(8), 2974. Int J Environ Res Public Health. 2020 May 27;17(11):3810. doi: 10.3390/ijerph17113810.

    PubMed 32471164
  • Singla D, Veqar Z. Association Between Forward Head, Rounded Shoulders, and Increased Thoracic Kyphosis: A Review of the Literature. J Chiropr Med. 2017 Sep;16(3):220-229. doi: 10.1016/j.jcm.2017.03.004. Epub 2017 Sep 28.

    PubMed 29097952
  • Ozdemir F, Toy S. Evaluation of scapular dyskinesis and ergonomic risk level in office workers. Int J Occup Saf Ergon. 2021 Dec;27(4):1193-1198. doi: 10.1080/10803548.2020.1757307. Epub 2020 Jun 22.

    PubMed 32306852
  • Christensen SW, Hirata RP, Graven-Nielsen T. The effect of experimental neck pain on pressure pain sensitivity and axioscapular motor control. J Pain. 2015 Apr;16(4):367-79. doi: 10.1016/j.jpain.2015.01.008. Epub 2015 Jan 29.

    PubMed 25640292
  • Castelein B, Cools A, Parlevliet T, Cagnie B. Are chronic neck pain, scapular dyskinesis and altered scapulothoracic muscle activity interrelated?: A case-control study with surface and fine-wire EMG. J Electromyogr Kinesiol. 2016 Dec;31:136-143. doi: 10.1016/j.jelekin.2016.10.008. Epub 2016 Oct 19.

    PubMed 27816845

Questions about this trial

What is this clinical trial studying?

A study testing Open chain kinetic exercises and Forward head posture correction exercises in people with Dyskinesias, run by Riphah International University at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Mar 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

SPADI questionnaire (time frame: 4 week). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05044572, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Mar 2022.

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